We have explored the use of an extracorporeal perfusion system that includes a membrane lung, to the treatment of hyaline membrane lung, to the treatment of hyaline membrane diase, adult respiratory distress syndrome, and meconium aspiration syndrome. Lungs were managed by apneic oxygention while on continuous positive pressure ventilation, and while metabolically produced CO2 was continuously removed by an extracorporeal membrane lung. Lungs so treated rapidly improved, resulting in a cure and long term survival. The perfusion system has been simplified, and now the perfusion can be performed though a single vein cannulation technique.